Provider Demographics
NPI:1285652669
Name:CASTRO, IRMA YOLANDA (MD)
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:YOLANDA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1300 N FRESNO ST
Mailing Address - Street 2:SUITE #220
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-3845
Mailing Address - Country:US
Mailing Address - Phone:559-495-6758
Mailing Address - Fax:559-495-6782
Practice Address - Street 1:1300 N FRESNO ST
Practice Address - Street 2:SUITE #220
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-3845
Practice Address - Country:US
Practice Address - Phone:559-495-6758
Practice Address - Fax:559-495-6782
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA49161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF37467Medicare UPIN